Collective Bargaining in Hospitals: An Organizational and Environmental Analysis

Abstract

The adoption of collective bargaining agreements in hospitals is conceptualized as resulting from conditions within the hospital that promote conflict and from social, legal and political constraints external to the hospital. It was predicted that hospitals with collective bargaining agreements would be characterized by greater (1) structural complexity, (2) environmental resource change, (3) environmental slack, (4) regulatory intensity, and (5) public or social accountability. Data for these analyses come from responses to national surveys of general, acute care hospitals (N = 3,813) conducted by the American Hospital Association in 1976, 1979, and 1980, and the Area Resource File. As predicted, organizational complexity was significantly related to the adoption of collective bargaining agreements. Regulatory intensity, environmental slack, and public accountability also were significant predictors of collective bargaining agreements. The effects of environmental resource change on collective bargaining differed for human and material resources. These results are consistent with the findings for collective bargaining in the industrial sector.

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